Virgilsen Line Flytkjær, Falborg Alina Zalounina, Vedsted Peter, Prior Anders, Pedersen Anette Fischer, Jensen Henry
Research Unit for General Practice, Aarhus, Bartholins Alle 2, 8000 Aarhus C, Denmark.
Research Unit for General Practice, Aarhus, Bartholins Alle 2, 8000 Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus C, Denmark.
Cancer Epidemiol. 2022 Dec;81:102293. doi: 10.1016/j.canep.2022.102293. Epub 2022 Nov 9.
Unplanned presentation in the cancer pathway is more common in patients with psychiatric disorders than in patients without. More knowledge about the risk factors for unplanned presentation could help target interventions to ensure earlier diagnosis of cancer in patients with psychiatric disorders. This study aims to estimate the association between patient characteristics (social characteristics and coexisting physical morbidity) and cancer diagnosis following unplanned presentation among cancer patients with psychiatric disorders. We conducted a population-based register study including patients diagnosed with cancer in 2014-2018 and also registered with at least one psychiatric disorder in the included Danish registers (n = 26,005). We used logistic regression to assess patient characteristics associated with an unplanned presentation. Almost one in four symptomatic patients (23.6 %) with pre-existing psychiatric disorders presented unplanned in the cancer trajectory. Unplanned presentation was most common for severe psychiatric disorders, e.g. organic disorders and schizophrenia. Old age, male sex, living alone, low education, physical comorbidity, and non-attendance in primary care were associated with increased odds of unplanned presentation. In conclusion, several characteristics of patients with pre-existing psychiatric disorders were associated with unplanned presentation in the cancer trajectory; for some groups more than 40 % had an unplanned presentation. This information could be used to design targeted interventions for patients with pre-existing psychiatric disorders to ensure earlier diagnosis of cancer in this population.
在癌症诊疗流程中，有精神疾病的患者比没有精神疾病的患者更常出现非计划性就诊情况。更多了解非计划性就诊的风险因素有助于确定干预目标，以确保精神疾病患者能更早诊断出癌症。本研究旨在评估精神疾病癌症患者的患者特征（社会特征和并存的躯体疾病）与非计划性就诊后的癌症诊断之间的关联。我们开展了一项基于人群的登记研究，纳入了2014 - 2018年被诊断患有癌症且在丹麦登记册中至少登记有一种精神疾病的患者（n = 26,005）。我们使用逻辑回归来评估与非计划性就诊相关的患者特征。近四分之一有既往精神疾病的有症状患者（23.6%）在癌症诊疗过程中出现非计划性就诊。非计划性就诊在严重精神疾病中最为常见，例如器质性疾病和精神分裂症。老年、男性、独居、低教育水平、躯体合并症以及未就诊于初级保健机构与非计划性就诊几率增加相关。总之，有既往精神疾病患者的若干特征与癌症诊疗过程中的非计划性就诊相关；对于某些群体，超过40%的患者出现非计划性就诊。这些信息可用于为有既往精神疾病的患者设计针对性干预措施，以确保该人群能更早诊断出癌症。
